Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:TBH, medication is a huge help if you can find one that works.

Don’t be afraid to try. Discuss with psychoatrist - there are many options. The main class of meds used for ADHD are stimulants, and they can be tried for a day and discontinued immediately if they have any negative side effects. The half life of stimulants is very short, which means that they don’t have effects that last days and once you stop them they are pretty much completely out of your system. If the stimulant is too high or an extended release your DD might be too stimulated to sleep. OTOH, by addressing her ADHD, she might be able to better stick to routines that help with sleep or be able to do homework more consistently and remember to turn it in and not worry about those things before sleep.

Also, there are other classes of medication that are NOT stimulants. Atomoxetine, for example, is not in the stimulant class. It is an SNRI shown to be effective with ADHD. It is thought to tamp down the DMN network of the brain which allows the brain network focused on task completion to operate more effectively. Tamping down the DMN can help diminish rumination, which may be a reason why your DD can’t fall asleep.

Also, there are many other aspects of sleep which should be investigated - sleep apnea? anxiety? And there may be other things that can help with sleep - exercise, early morning light, melatonin, magnesium, etc.

Your kid should be fully evaluated by a psychiatrist who can help you discuss options and do med trials.

the research shows that there may be short-term benefits of meds, but not long-term. I don’t say this to challenge/criticize anyone who found meds helpful for themselves or their child. but rather to reassure OP that she has a reasonable basis to choose not to medicate.

That's not what DC's psychiatrist said. She made a very compelling case for medicating based on the research on long term outcomes for medicated vs non medicated.

+1 I have not seen replicated, high quality research that backs what the first poster is saying. I agree with others op that if you are seeing self esteem impacts it is incredibly worthwhile to consider it. I have a child with ADHD and worked in this area professionally prior and in my personal experience, parents highly underestimate the "side effects" of struggling through this without the support of medication due to fear over potential medication side effects. I totally get it, I've been there myself, but the impacts on kids that can lead to other issues (anxiety, depression later) are really important to consider.

Talk to a psychiatrist. Don't count it out without at least talking to someone who is really an expert in this. Your concerns are so valid and we do use melatonin to help my son fall asleep due to the stimulant but it has been so, so worth it. There are also non-stimulant ADHD meds that can actually help with sleep, though I believe they usually aren't as helpful with the focus piece so may not be the right fit. But a good child psychiatrist will know waht the options are and insomnia is a common adhd symptom so you aren't alone! you are certainly not the only family navigating it and a good child psychiatrist will have seen many families through it.

You don’t thing the NIH project is reputable and long-running? Ok.

Again no issue with people who chose medication. But the scare tactics and pronouncements about it are way too much.

Anonymous wrote:

Anonymous wrote:How old is your child?
We were able to manage without medication until middle school.
I guess the answer is, you can manage without medication until you can't anymore. You will know when the time comes.

Op here. Thank you and this is what I'm thinking. She's in 4th grade. It's not hard to manage now, but as she gets older and is required to do more on her own (i.e. manage homework, study guides, a planner), I can tell she needs more support from us. For a long time she's been able to coast with smarts and background knowledge, but I think those days are numbered.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:TBH, medication is a huge help if you can find one that works.

Don’t be afraid to try. Discuss with psychoatrist - there are many options. The main class of meds used for ADHD are stimulants, and they can be tried for a day and discontinued immediately if they have any negative side effects. The half life of stimulants is very short, which means that they don’t have effects that last days and once you stop them they are pretty much completely out of your system. If the stimulant is too high or an extended release your DD might be too stimulated to sleep. OTOH, by addressing her ADHD, she might be able to better stick to routines that help with sleep or be able to do homework more consistently and remember to turn it in and not worry about those things before sleep.

Also, there are other classes of medication that are NOT stimulants. Atomoxetine, for example, is not in the stimulant class. It is an SNRI shown to be effective with ADHD. It is thought to tamp down the DMN network of the brain which allows the brain network focused on task completion to operate more effectively. Tamping down the DMN can help diminish rumination, which may be a reason why your DD can’t fall asleep.

Also, there are many other aspects of sleep which should be investigated - sleep apnea? anxiety? And there may be other things that can help with sleep - exercise, early morning light, melatonin, magnesium, etc.

Your kid should be fully evaluated by a psychiatrist who can help you discuss options and do med trials.

the research shows that there may be short-term benefits of meds, but not long-term. I don’t say this to challenge/criticize anyone who found meds helpful for themselves or their child. but rather to reassure OP that she has a reasonable basis to choose not to medicate.

That's not what DC's psychiatrist said. She made a very compelling case for medicating based on the research on long term outcomes for medicated vs non medicated.

+1 I have not seen replicated, high quality research that backs what the first poster is saying. I agree with others op that if you are seeing self esteem impacts it is incredibly worthwhile to consider it. I have a child with ADHD and worked in this area professionally prior and in my personal experience, parents highly underestimate the "side effects" of struggling through this without the support of medication due to fear over potential medication side effects. I totally get it, I've been there myself, but the impacts on kids that can lead to other issues (anxiety, depression later) are really important to consider.

Talk to a psychiatrist. Don't count it out without at least talking to someone who is really an expert in this. Your concerns are so valid and we do use melatonin to help my son fall asleep due to the stimulant but it has been so, so worth it. There are also non-stimulant ADHD meds that can actually help with sleep, though I believe they usually aren't as helpful with the focus piece so may not be the right fit. But a good child psychiatrist will know waht the options are and insomnia is a common adhd symptom so you aren't alone! you are certainly not the only family navigating it and a good child psychiatrist will have seen many families through it.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:TBH, medication is a huge help if you can find one that works.

Don’t be afraid to try. Discuss with psychoatrist - there are many options. The main class of meds used for ADHD are stimulants, and they can be tried for a day and discontinued immediately if they have any negative side effects. The half life of stimulants is very short, which means that they don’t have effects that last days and once you stop them they are pretty much completely out of your system. If the stimulant is too high or an extended release your DD might be too stimulated to sleep. OTOH, by addressing her ADHD, she might be able to better stick to routines that help with sleep or be able to do homework more consistently and remember to turn it in and not worry about those things before sleep.

Also, there are other classes of medication that are NOT stimulants. Atomoxetine, for example, is not in the stimulant class. It is an SNRI shown to be effective with ADHD. It is thought to tamp down the DMN network of the brain which allows the brain network focused on task completion to operate more effectively. Tamping down the DMN can help diminish rumination, which may be a reason why your DD can’t fall asleep.

Also, there are many other aspects of sleep which should be investigated - sleep apnea? anxiety? And there may be other things that can help with sleep - exercise, early morning light, melatonin, magnesium, etc.

Your kid should be fully evaluated by a psychiatrist who can help you discuss options and do med trials.

the research shows that there may be short-term benefits of meds, but not long-term. I don’t say this to challenge/criticize anyone who found meds helpful for themselves or their child. but rather to reassure OP that she has a reasonable basis to choose not to medicate.

That's not what DC's psychiatrist said. She made a very compelling case for medicating based on the research on long term outcomes for medicated vs non medicated.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How old is your child?
We were able to manage without medication until middle school.
I guess the answer is, you can manage without medication until you can't anymore. You will know when the time comes.

This was our experience too. Was able to manage without medication for a long time, but when middle school came, the work demands increased, the willingness of teachers to tolerate his talking/fidgeting/wandering/etc decreased and he was getting in trouble every day/getting C/D's on assignments, missing assignments, etc - he was frustrated with himself and his self esteem plummeted. DH finally agreed it was time to try meds. He started meds and we stopped getting daily notes home re: his behavior, his grades increased to A/B, and his self esteem improved dramatically. This was 7y ago and he is now a senior taking AP/IB/DE classes with all A/B's, multiple sports, and a job. When his meds wear off at night I was see what he would be like unmedicated and I am 100000% he wouldn't have been able to manage as well as he does now.

You'll know.

Thank you! This is reassuring. I'm seeing the self-esteem stuff starting to creep in even now. She gets so frustrated when she forgets things or doesn't follow through and says things that break my heart. It's also so so hard for us to find the balance between total helicopter and completely dropping the rope on some things. I think my husband and I need some help with that.

One tip that our therapist gave us was to help her master one skill at a time. When she shows mastery, move on to the next thing. Our dd wasn’t able to handle learning to organize her school papers and cleaning up after herself and having good table manners, and fixing her own hair, and managing her time all at once. I was trying to teach her all life skills simultaneously, like I did with my neurotypical child, but that made my child with ADHD feel like a failure because she wasn’t truly mastering any one skill.

OP here - OMG get this us. This is awesome advice. Thank you!

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:TBH, medication is a huge help if you can find one that works.

Don’t be afraid to try. Discuss with psychoatrist - there are many options. The main class of meds used for ADHD are stimulants, and they can be tried for a day and discontinued immediately if they have any negative side effects. The half life of stimulants is very short, which means that they don’t have effects that last days and once you stop them they are pretty much completely out of your system. If the stimulant is too high or an extended release your DD might be too stimulated to sleep. OTOH, by addressing her ADHD, she might be able to better stick to routines that help with sleep or be able to do homework more consistently and remember to turn it in and not worry about those things before sleep.

Also, there are other classes of medication that are NOT stimulants. Atomoxetine, for example, is not in the stimulant class. It is an SNRI shown to be effective with ADHD. It is thought to tamp down the DMN network of the brain which allows the brain network focused on task completion to operate more effectively. Tamping down the DMN can help diminish rumination, which may be a reason why your DD can’t fall asleep.

Also, there are many other aspects of sleep which should be investigated - sleep apnea? anxiety? And there may be other things that can help with sleep - exercise, early morning light, melatonin, magnesium, etc.

Your kid should be fully evaluated by a psychiatrist who can help you discuss options and do med trials.

the research shows that there may be short-term benefits of meds, but not long-term. I don’t say this to challenge/criticize anyone who found meds helpful for themselves or their child. but rather to reassure OP that she has a reasonable basis to choose not to medicate.

I'm not sure this is true. I've seen at least two researchers (can't find the links now) that cited studies that showed kids who took meds in childhood actually saw a reduction of symptoms as adults. Definitely something you might want to look up or ask your health care providers about. But overall, a lot is going to depend on your child as to how well she can manage on her own and how the meds hit her.

FWIW, we have tried several meds during elementary, but still haven't found the "one," as my kiddo is so sensitive to the side effects, that we can't get to a dosage high enough to see any benefit. After a lengthy break where we focused on behavior management and therapy only, we're trying again now with the methylphenidate patch, which he's been able to tolerate better, but it makes him sleepy, so not sure if we're just substituting one focus issue for another.

Thank you, this is my understanding of the current research too - that there are definite long term benefits to medication in childhood. That and a few other reasons convinced us it was time to medicate.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:TBH, medication is a huge help if you can find one that works.

Don’t be afraid to try. Discuss with psychoatrist - there are many options. The main class of meds used for ADHD are stimulants, and they can be tried for a day and discontinued immediately if they have any negative side effects. The half life of stimulants is very short, which means that they don’t have effects that last days and once you stop them they are pretty much completely out of your system. If the stimulant is too high or an extended release your DD might be too stimulated to sleep. OTOH, by addressing her ADHD, she might be able to better stick to routines that help with sleep or be able to do homework more consistently and remember to turn it in and not worry about those things before sleep.

Also, there are other classes of medication that are NOT stimulants. Atomoxetine, for example, is not in the stimulant class. It is an SNRI shown to be effective with ADHD. It is thought to tamp down the DMN network of the brain which allows the brain network focused on task completion to operate more effectively. Tamping down the DMN can help diminish rumination, which may be a reason why your DD can’t fall asleep.

Also, there are many other aspects of sleep which should be investigated - sleep apnea? anxiety? And there may be other things that can help with sleep - exercise, early morning light, melatonin, magnesium, etc.

Your kid should be fully evaluated by a psychiatrist who can help you discuss options and do med trials.

the research shows that there may be short-term benefits of meds, but not long-term. I don’t say this to challenge/criticize anyone who found meds helpful for themselves or their child. but rather to reassure OP that she has a reasonable basis to choose not to medicate.

I'm not sure this is true. I've seen at least two researchers (can't find the links now) that cited studies that showed kids who took meds in childhood actually saw a reduction of symptoms as adults. Definitely something you might want to look up or ask your health care providers about. But overall, a lot is going to depend on your child as to how well she can manage on her own and how the meds hit her.

FWIW, we have tried several meds during elementary, but still haven't found the "one," as my kiddo is so sensitive to the side effects, that we can't get to a dosage high enough to see any benefit. After a lengthy break where we focused on behavior management and therapy only, we're trying again now with the methylphenidate patch, which he's been able to tolerate better, but it makes him sleepy, so not sure if we're just substituting one focus issue for another.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How old is your child?
We were able to manage without medication until middle school.
I guess the answer is, you can manage without medication until you can't anymore. You will know when the time comes.

This was our experience too. Was able to manage without medication for a long time, but when middle school came, the work demands increased, the willingness of teachers to tolerate his talking/fidgeting/wandering/etc decreased and he was getting in trouble every day/getting C/D's on assignments, missing assignments, etc - he was frustrated with himself and his self esteem plummeted. DH finally agreed it was time to try meds. He started meds and we stopped getting daily notes home re: his behavior, his grades increased to A/B, and his self esteem improved dramatically. This was 7y ago and he is now a senior taking AP/IB/DE classes with all A/B's, multiple sports, and a job. When his meds wear off at night I was see what he would be like unmedicated and I am 100000% he wouldn't have been able to manage as well as he does now.

You'll know.

Thank you! This is reassuring. I'm seeing the self-esteem stuff starting to creep in even now. She gets so frustrated when she forgets things or doesn't follow through and says things that break my heart. It's also so so hard for us to find the balance between total helicopter and completely dropping the rope on some things. I think my husband and I need some help with that.

One tip that our therapist gave us was to help her master one skill at a time. When she shows mastery, move on to the next thing. Our dd wasn’t able to handle learning to organize her school papers and cleaning up after herself and having good table manners, and fixing her own hair, and managing her time all at once. I was trying to teach her all life skills simultaneously, like I did with my neurotypical child, but that made my child with ADHD feel like a failure because she wasn’t truly mastering any one skill.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How old is your child?
We were able to manage without medication until middle school.
I guess the answer is, you can manage without medication until you can't anymore. You will know when the time comes.

This was our experience too. Was able to manage without medication for a long time, but when middle school came, the work demands increased, the willingness of teachers to tolerate his talking/fidgeting/wandering/etc decreased and he was getting in trouble every day/getting C/D's on assignments, missing assignments, etc - he was frustrated with himself and his self esteem plummeted. DH finally agreed it was time to try meds. He started meds and we stopped getting daily notes home re: his behavior, his grades increased to A/B, and his self esteem improved dramatically. This was 7y ago and he is now a senior taking AP/IB/DE classes with all A/B's, multiple sports, and a job. When his meds wear off at night I was see what he would be like unmedicated and I am 100000% he wouldn't have been able to manage as well as he does now.

You'll know.

Thank you! This is reassuring. I'm seeing the self-esteem stuff starting to creep in even now. She gets so frustrated when she forgets things or doesn't follow through and says things that break my heart. It's also so so hard for us to find the balance between total helicopter and completely dropping the rope on some things. I think my husband and I need some help with that.

Anonymous wrote:

Anonymous wrote:Its so hard to find anyone on this forum who doesn't medicate. I have a kid with similar issues, and the answer is always "who cares if your kid will have tics from meds, at least their homework is done".

No, I think you need to find a provider who will work with you. DC had tics pre medication. We didn't get DC medicated by a pediatrician, we went to a very good psychiatrist who chose meds carefully based on history of tics and used low dosages working up.

So we were able to put DC on meds without increasing the tics. It can be done.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:TBH, medication is a huge help if you can find one that works.

Don’t be afraid to try. Discuss with psychoatrist - there are many options. The main class of meds used for ADHD are stimulants, and they can be tried for a day and discontinued immediately if they have any negative side effects. The half life of stimulants is very short, which means that they don’t have effects that last days and once you stop them they are pretty much completely out of your system. If the stimulant is too high or an extended release your DD might be too stimulated to sleep. OTOH, by addressing her ADHD, she might be able to better stick to routines that help with sleep or be able to do homework more consistently and remember to turn it in and not worry about those things before sleep.

Also, there are other classes of medication that are NOT stimulants. Atomoxetine, for example, is not in the stimulant class. It is an SNRI shown to be effective with ADHD. It is thought to tamp down the DMN network of the brain which allows the brain network focused on task completion to operate more effectively. Tamping down the DMN can help diminish rumination, which may be a reason why your DD can’t fall asleep.

Also, there are many other aspects of sleep which should be investigated - sleep apnea? anxiety? And there may be other things that can help with sleep - exercise, early morning light, melatonin, magnesium, etc.

Your kid should be fully evaluated by a psychiatrist who can help you discuss options and do med trials.

the research shows that there may be short-term benefits of meds, but not long-term. I don’t say this to challenge/criticize anyone who found meds helpful for themselves or their child. but rather to reassure OP that she has a reasonable basis to choose not to medicate.

I'm not sure this is true. I've seen at least two researchers (can't find the links now) that cited studies that showed kids who took meds in childhood actually saw a reduction of symptoms as adults. Definitely something you might want to look up or ask your health care providers about. But overall, a lot is going to depend on your child as to how well she can manage on her own and how the meds hit her.

FWIW, we have tried several meds during elementary, but still haven't found the "one," as my kiddo is so sensitive to the side effects, that we can't get to a dosage high enough to see any benefit. After a lengthy break where we focused on behavior management and therapy only, we're trying again now with the methylphenidate patch, which he's been able to tolerate better, but it makes him sleepy, so not sure if we're just substituting one focus issue for another.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How old is your child?
We were able to manage without medication until middle school.
I guess the answer is, you can manage without medication until you can't anymore. You will know when the time comes.

This was our experience too. Was able to manage without medication for a long time, but when middle school came, the work demands increased, the willingness of teachers to tolerate his talking/fidgeting/wandering/etc decreased and he was getting in trouble every day/getting C/D's on assignments, missing assignments, etc - he was frustrated with himself and his self esteem plummeted. DH finally agreed it was time to try meds. He started meds and we stopped getting daily notes home re: his behavior, his grades increased to A/B, and his self esteem improved dramatically. This was 7y ago and he is now a senior taking AP/IB/DE classes with all A/B's, multiple sports, and a job. When his meds wear off at night I was see what he would be like unmedicated and I am 100000% he wouldn't have been able to manage as well as he does now.

You'll know.

Thank you! This is reassuring. I'm seeing the self-esteem stuff starting to creep in even now. She gets so frustrated when she forgets things or doesn't follow through and says things that break my heart. It's also so so hard for us to find the balance between total helicopter and completely dropping the rope on some things. I think my husband and I need some help with that.

Anonymous wrote:

Anonymous wrote:TBH, medication is a huge help if you can find one that works.

Don’t be afraid to try. Discuss with psychoatrist - there are many options. The main class of meds used for ADHD are stimulants, and they can be tried for a day and discontinued immediately if they have any negative side effects. The half life of stimulants is very short, which means that they don’t have effects that last days and once you stop them they are pretty much completely out of your system. If the stimulant is too high or an extended release your DD might be too stimulated to sleep. OTOH, by addressing her ADHD, she might be able to better stick to routines that help with sleep or be able to do homework more consistently and remember to turn it in and not worry about those things before sleep.

Also, there are other classes of medication that are NOT stimulants. Atomoxetine, for example, is not in the stimulant class. It is an SNRI shown to be effective with ADHD. It is thought to tamp down the DMN network of the brain which allows the brain network focused on task completion to operate more effectively. Tamping down the DMN can help diminish rumination, which may be a reason why your DD can’t fall asleep.

Also, there are many other aspects of sleep which should be investigated - sleep apnea? anxiety? And there may be other things that can help with sleep - exercise, early morning light, melatonin, magnesium, etc.

Your kid should be fully evaluated by a psychiatrist who can help you discuss options and do med trials.

the research shows that there may be short-term benefits of meds, but not long-term. I don’t say this to challenge/criticize anyone who found meds helpful for themselves or their child. but rather to reassure OP that she has a reasonable basis to choose not to medicate.

Anonymous wrote:Its so hard to find anyone on this forum who doesn't medicate. I have a kid with similar issues, and the answer is always "who cares if your kid will have tics from meds, at least their homework is done".